Elbow tendinopathies: epicondylitis and epitrochleitis

What is

Tendinopathies in the elbow joint are caused by the deterioration of the tendons that join the different muscles with the bones that form part of this joint. Its development is usually slow and the pain progressive; it is not rare that partial or total tendon ruptures occur, so it is important to act as soon as possible on the factors that lead to the deterioration and subsequent possible rupture of the tendon.

Type

Epicondylitis (Tennis Elbow)

Epicondylitis or tennis elbow is caused by wear and inflammation of the tendons that join the forearm muscles on the outside of the elbow and are involved in the extension of the wrist and fingers.
This injury is usually caused by overuse of these muscles in racquet sports such as tennis, paddle tennis and squash. This causes pain and tenderness to pressure on the outside of the elbow.

Epitrochleitis (Golfer's Elbow)

Epitrocleitis is the inflammation and degeneration of the tendons that attach the forearm muscles to the inside of the elbow.
It is one of the most common causes of elbow pain and is usually related to activities and sports such as golf, climbing or volleyball.
It is caused by wear and tear of the insertion in the bone of the muscles that allow flexion of the wrist.

Symptoms

Symptoms usually appear gradually, i.e. the pain increases slowly with increasing wear and tear. The pain appears on the outside (epicondylitis) or inside of the elbow (epitrochleitis) and as it progresses, there is a decrease in grip strength.

Approach protocol

Diagnosis and assessment

A correct medical evaluation will be necessary by means of a good anamnesis, physical examination and, if necessary, with the support of imaging tests. Focusing especially on identifying the factors that lead to tendon overload (in this phase the biomechanics and the physical trainer will be fundamental) and assessing whether the injury is exclusively a tendinopathy, if there is a rupture or if there are associated calcifications. This will allow to select the best treatment.

Complementary tests

X-ray and/or MRI.

Treatment

The treatment will depend on the doctor’s diagnosis and the degree of deterioration of the tendon, depending on it may be applied:

Drugs for pain relief
Physiotherapy: methodology based on knowledge and clinical reasoning in which we combine a series of techniques and treatments both manual therapy and invasive techniques, always associated or complementing them with cutting-edge technology that allows us to accelerate the recovery process. Among other high-tech devices include Magnetolith, SIS, focal shock waves, Indiba, among others. This therapeutic combination allows us to activate the patient early to begin with a routine and a process of specific therapeutic exercises that allow us to enhance and strengthen the lost functional patterns.
Interventional treatments:
- Regenerative medicine treatments
  - Platelet-rich plasma: the compound extracted from the patient’s own blood has a concentrate of anti-inflammatory factors and cytokines that make it very useful for this pathology.
  - Cytokine-rich serum: this is a different process to platelet-rich plasma in which a compound rich in anti-inflammatory cytokines is also obtained from the blood.
  - Stem cells: originating from the patient’s bone or fat, they have a regenerative and anti-inflammatory power that makes them a unique treatment for pain relief.
- Hyaluronic acid treatment
- Nerve blocks

Here begins your life without pain

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Stig Herbern

14 hours ago

Very professional and the treatment has helped me to survive the summer. I had one injection in May but due to too much tension it did not work as well and I was offered a new treatment mid July that worked much better. The injection are done at the Kiron hospital in a very professional setting. Both the doctor and the assistant are client oriented and make you feel taken care of.

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16 hours ago

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Gran equipo Pablo muy apañado felicitaciones

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2 weeks ago

Quiero compartir y agradecer a la Dtra.Natalia Neira su gran trabajo y ser una gran profesional,simpatía y amabilidad,en su gran trabajo día a día.Gracias Dtra.

Horacio Helmann

2 weeks ago

Las intervenciones que me ha realizado el Doctor han sido un exito y la atención del personal muy buena , recomendado !!!

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Thess

2 weeks ago

I have experienced the utmost professional and reliable advice and help from this unit. Struggling with Meralgia Parastetica for over 2 years and intense discomfort and pain during the past 8 months I am now finally getting the help I needed. First with a nerve block, then an ablation on my trapped nerve. I truly recommend this pain unit, their staff and in my case Surgeon Dr Alejandro Miras Garcia.